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What’s a Posterior Crossbite?

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A posterior crossbite occurs when the back teeth sit behind the lower molars, causing misalignment and potential dental problems. Orthodontic treatments, such as braces or retainers, can correct the issue, but early treatment is important. Causes include thumb or pacifier sucking, narrowed airways, and genetics. Fixed spring-loaded devices and surgically implanted devices can also be used. Treatment of baby teeth can prevent the issue from occurring with adult teeth.

A normal bite is when the teeth on the upper jaw generally sit just above the lower teeth. When the back teeth, or molars, sit behind the lower molars when the jaw is closed, dentists usually refer to it as a posterior crossbite. The problem can be on one side or both sides of the mouth. Sometimes it involves one tooth, but more than one or all of them can be affected. Orthodontists can correct the problem with braces, removable devices called retainers, or implantable devices that spread the palate bones back into a normal position.

With a posterior crossbite, the entire upper row of teeth, called the dental arch, is typically arranged in a V rather than a U shape. It is generally referred to as a unilateral crossbite if it occurs on one side and a bilateral crossbite if both sides they are interested. Children and adults can develop a posterior crossbite and usually, the sooner it is treated, the better. If this condition is not corrected, serious dental problems can occur, so early treatment can be an important preventative measure.

Teeth can wear down much faster if there is a back crossbite. Misalignment of the back teeth sometimes leads to gum disease, bone loss around the tooth roots, and even abnormal jaw development. People can also develop abnormal chewing patterns. There are various causes for rear crossbite, but sometimes it develops from thumb or pacifier sucking, narrowed airways, and genetic reasons. The bite pattern generally does not revert to a normal bite unless treated by an orthodontist.

To correct posterior crossbite, there are different types of orthodontic treatments. Braces are sometimes used to fix the bite. Appliances such as retainers are often used to move the back teeth into the right position. These are typically removable, but sometimes a surgically implanted device is used to expand the palate. The palate can be pulled apart when a screw is turned, and the separate bones usually grow together once they are repositioned.

There are also fixed spring-loaded devices that usually do not require adjustment during treatment. In clinical studies, when a posterior crossbite of baby teeth is treated, the problem is generally less likely to occur with the adult dentition. The choice of treatment usually does not affect the outcome. Some patients, however, may require more aggressive procedures than others.

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